The FDA said the results of a recent study showed that children exposed to valproate products in the womb had lower IQ at the age of six than children who were exposed to other antiepileptics.
Drugs containing valproate are used to prevent migraine headaches, treat epileptic seizures and manic episodes associated with bipolar disorder.
Abbott Laboratories’ Depacon, Depakote, Depakote CP, Depakote ER and Depakene, and Noven Therapeutics LLC’s Stavzor and their generics contain valproate.
Drugs containing valproate already carry a boxed warning for birth defects.]]>
The majority of migraine sufferers try to figure out for themselves what causes their headaches based on real world conditions, said lead author Timothy T. Houle, Ph.D, associate professor of anesthesia and neurology at Wake Forest Baptist.
“But our research shows this is a flawed approach for several reasons,” he said. “Correctly identifying triggers allows patients to avoid or manage them in an attempt to prevent future headaches. However, daily fluctuations of variables such as weather, diet, hormone levels, sleep, physical activity and stress ֖ appear to be enough to prevent the perfect conditions necessary for determining triggers.”
For example, said Houle, the simple act of drinking a glass of wine one day and not on the next could be complicated by inconsistencies in other factors. Similarly, a patient may drink wine for several days, but adding cheese to the mix one day could further skew results. In fact, a valid self-evaluation requires such perfect conditions that only occur about once every two years, he said.]]>
“People with migraine with aura are told to avoid possible triggers, which may lead them to avoid a wide range of suspected factors,” said study author Jes Olesen, MD, with the University of Copenhagen in Denmark and a Fellow of the American Academy of Neurology. “Yet the most commonly reported triggers are stress, bright light, emotional influences and physical effort, which can be difficult to avoid and potentially detrimental, if people avoid all physical activity.”
The study involved 27 people with migraine with aura who reported that bright or flickering light, vigorous exercise, or both, previously triggered an attack. The participants were then exposed to the triggers to see if they caused a headache episode.
Participants either went for an intense run or used an exercise bike for one hour, reaching at least 80 percent of their maximum heart rate. Participants also were exposed to bright, flashing or flickering lights for 30 to 40 minutes. After each session, the participants were monitored for about three hours and asked to report any migraine or migraine with aura symptoms.]]>
In this retrospective study, which was conducted at the ophthalmology clinic of Albany Medical Center in New York state, researchers reviewed the medical records of 158 children under age 18 who were seen at the clinic for frequent headaches from 2002-11. All of the children received complete eye exams by the clinic’s ophthalmologists.
No significant correlation was found between their frequent headaches and a need for vision correction. The researchers reached this conclusion by comparing the results of the clinic’s exams of the children with headaches to the records of their previous eye exams and other relevant medical care. Eye health and vision test results remained unchanged from earlier exams for 75 percent of the children. Also, children who already had eyeglasses were not found to need new prescriptions at the time they were seen at the clinic for headaches. Although about 14 percent of the children reported that their headaches occurred while doing visual tasks like homework, and about nine percent reported visual symptoms associated with their headaches, a need for vision correction did not appear to be the primary cause or a significant factor in any of these cases, according to the study.]]>
The clinic’s annual list of the best medical innovations for 2013 also includes new drugs to treat advanced prostate cancer and better mammography technology.
But leading the 2013 list for innovations is an old procedure that has a new use due to findings in a recent study. Physicians and researchers at the clinic voted weight-loss surgery as the top medical innovation, not for its effectiveness in reducing obesity, but for its ability to control Type 2 diabetes, the most common form of the disease.
Over the years, bariatric surgeons noticed that the procedure would often rid obese patients of Type 2 diabetes, before they even left the hospital.]]>
The national survey found that of 245 neurologists, 35 percent said they’d ever had migraine headaches. And 26 percent had had one in the past year - double what’s reported among Norwegians as a whole.
Worldwide, an estimated 11 percent of people have suffered a migraine in the past year.
It’s not clear why neurologists are so taxed by migraines. But one possibility is that the general public actually has higher migraine rates, but doesn’t realize it or report the headaches, according to the researchers, led by Dr. Karl B. Alstadhaug of Nordland Hospital in Bodo, Norway.]]>
The new genes identified in this study provide further evidence for the hypothesis that dysregulation of molecules important in transmitting signals between brain neurons contribute to migraine. Two of the genes support the hypothesis of a possible role of blood vessels and thus disturbances in blood flow.
The researchers carried out what is known as a genome-wide association study (GWAS) to zoom in on genome variants that could increase susceptibility to migraine; they compared genomes of 4800 migraine patients with more than 7000 non-migraine individuals. The project was performed by the International Headache Genetics Consortium consisting of leading migraine researches from Europe and Australia.
This was the third report on genes predisposing people to common forms of migraine, but the first one on the most common migraine subtype. “The study establishes for the first time a specific gene that contributes to this common disease” said Professor Aarno Palotie at FIMM and the Wellcome Trust Sanger Institute, the chair of the International Headache Genetics Consortium.]]>
Patients who started out having headaches almost every day reported two fewer headaches per month when they were given injections of botulinum toxin A. But they also had more side effects, including weak muscles and stiff necks.
The medication is marketed under multiple brands, but Allergan’s Botox is the best known. Botox is used to treat a range of conditions in addition to migraines, including wrinkles and excessive sweating.]]>
An evidence review by the AAN and the American Headache Society also identified several over-the-counter (OTC) products, including herbal supplements, with either proven or probable efficacy.
The announcement accompanied publication of two practice guidelines on prevention of episodic migraine - one for prescription products and another for nonsteroid anti-inflammatory drugs and “complementary” therapies - in the April 24 issue of Neurology.
Prescription drugs listed as having proven effectiveness against migraine, defined as a significant benefit in at least two high-quality randomized trials, included one triptan agent, three beta-blockers, and three anti-epileptic drugs.]]>
Dr. Tobias Köhler of Southern Illinois University School of Medicine, who specializes in male sexual function and fertility, told Reuters Health this is the first he’s heard of any such relationship between migraines and impotence.
“It’s an interesting first recognition of the correlation, but by no means does it mean they’re causally linked,” said Köhler, who was not involved in the new research. It’s not clear what might explain the link between erectile dysfunction (ED) and headache, although migraines have been linked to sexual dysfunction in women, the study authors note in the journal Cephalalgia.]]>
The findings don’t prove that headaches caused the suicide attempts, but a number of studies over the years have found that people with migraines tend to have a higher suicide rate than those without the problem.
But it has not been clear whether it’s related specifically to the “biology of migraines,” said Naomi Breslau of Michigan State University in East Lansing, who led the new study.
“We haven’t known if it was the migraines or the pain more generally,” Breslau told Reuters Health.]]>
The work raises the question of whether colic may be an early symptom of migraine and therefore whether reducing stimulation may help just as reducing light and noise can alleviate migraine pain. That is significant because excessive crying is one of the most common triggers for shaken baby syndrome, which can cause death, brain damage and severe disability.
“If we can understand what is making the babies cry, we may be able to protect them from this very dangerous outcome,” said Amy Gelfand, MD, a child neurologist with the Headache Center at UCSF who will present the findings at the American Academy of Neurology’s 64th Annual Meeting, which takes place in New Orleans in April.]]>
The new guidelines represent an expert consensus summary, and recommend a contemporary, standardized, and evidence-based approach to investigators conducting and reporting randomised, controlled migraine clinical trials.
Migraine clinical research has increased exponentially since the last set of guidelines was published. Clinical researchers and pharmaceutical companies have accumulated further experience, and the trend is towards large, multi-national and multi-centre studies. Given these developments, it was timely to bring the guidelines up to date.
The IHS stresses that it endorses adherence to the guidelines unless there is scientific justification to deviate from them. They represent research practice parameters and are the highest level in the hierarchy of evidence-based recommendations in the absence of published standards of research practice.]]>
While not entirely surprising, the results point to a difficult long-term problem for kids and their parents because adequate treatments are lacking, researchers say.
“It’s an issue because they may have problems with sleep, and the headaches can make it harder to concentrate,” said lead author Dr. Heidi Blume at Seattle Children’s Research Institute.]]>
The research, published in the journal Headache, also hints that the relationship may go both ways, and people with clinical depression could have a higher risk of developing migraines, but that finding could have been due to chance, the researchers say.
Nonetheless, lead author Geeta Modgill, who was at the University of Calgary while conducting the work, told Reuters Health that migraine and depression sufferers should know the signs of both ailments since each might be at a higher risk for the other condition.]]>